Individual
MR. STEVEN JAMES CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD0001859
Contact information
Practice address
4292 GRAY HWY, SUITE A, GRAY, GA 31032
(478) 986-2384
(478) 986-2301
Mailing address
4292 GRAY HWY, SUITE A, GRAY, GA 31032
(478) 986-2384
(478) 986-2301
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LD0001859
GA
Other
Enumeration date
04/30/2007
Last updated
07/08/2007
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